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CLINICAL IMAGES
Year : 2015  |  Volume : 141  |  Issue : 6  |  Page : 844

Lumbar hernia of Grynfeltt's triangle


1 Division of Hematology-Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defence Medical Center, Taipei, Taiwan
2 Department of General Surgery, Tri-Service General Hospital, National Defence Medical Center, Taipei, Taiwan

Date of Web Publication14-Jul-2015

Correspondence Address:
Kuan-Yu Chen
Department of General Surgery, Tri-Service General Hospital, National Defence Medical Center, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.160734

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How to cite this article:
Lai SW, Chen KY. Lumbar hernia of Grynfeltt's triangle. Indian J Med Res 2015;141:844

How to cite this URL:
Lai SW, Chen KY. Lumbar hernia of Grynfeltt's triangle. Indian J Med Res [serial online] 2015 [cited 2020 Mar 29];141:844. Available from: http://www.ijmr.org.in/text.asp?2015/141/6/844/160734

A 76 year old man presented to the emergency department, Tri-Service General Hospital, Taiwan, with intermittent dull abdominal pain for three weeks in August 2013. One reducible soft mass was found over his left flank under the ribs and enlarged when coughing. The computed tomography (CT) of abdomen demonstrated a herniation of retroperitoneal fat through left superior lumbar space, also known as Grynfeltt triangle [Figure 1]
Figure 1. The computed tomography of abdomen showed retroperitoneal fat protruding through Grynfeltt's triangle (bold red arrow) bound by the 12th rib superiorly (thin red arrow), the quadratus lumborum muscle medially (triangle), and internal oblique muscle laterally (asterisk). Fig. 2A. The operation demonstrated a soft, tympanic and compressible herniated sac with a smooth surface (arrows). 2B. The defect was repaired by direct apposition of the internal oblique muscle and fascia with non-absorbable sutures.

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. He underwent lumbar oblique incision to return the hernia sac and repaired the defect by layered closure in a right decubitus position

[Figure 2]Aand 2B). The patient exhibited no symptoms six months after discharge. {Figure 2}

Grynfeltt hernia may sometimes cause incarceration, strangulation, and bowel obstruction. Enlarged bulging size is an important clue to differentiate from lipoma by increasing intra-abdominal pressure, such as coughing. Prompt abdominal CT and early surgical repair can prevent possible bowel ischaemia.


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